Gyrostim Operation Guide
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Questions and Answers

What is the first step in turning on the Gyrostim?

  • Push the green button on the control panel
  • Calibrate the chair
  • Start the Gyrostim software
  • Turn on the switch on the bottom left (correct)

    • Which of the following steps must be taken when putting a patient in the Gyrostim?

  • Lower the steps down to the ground before closing the door (correct)
  • Close the door before adjusting the straps
  • Adjust the footrest height after the belts are tightened
  • Tighten the lap belt before the 5 point harness

    • What does the nomenclature 'A1' stand for in a custom protocol?

  • Alternating speed
  • Acceleration at a steady rate
  • Acceleration of 1 second (correct)
  • Angled rotation

    • Which parameter must be checked between reps to ensure patient safety?

    <p>Sweatiness of palms</p> Signup and view all the answers

    What does the 'RUN Gyrostim' tab allow you to do?

    <p>Access basic protocols</p> Signup and view all the answers

    What is a key consideration when determining therapy goals with Gyrostim?

    <p>Fast phase versus slow phase stimulation</p> Signup and view all the answers

    What does 'D1' indicate in the Gyrostim nomenclature?

    <p>Deceleration of 1 second</p> Signup and view all the answers

    What action should be taken if a patient shows signs of fatigue during Gyrostim therapy?

    <p>Take a break and monitor their condition</p> Signup and view all the answers

    What is the primary purpose of the basic protocol designed for individuals with ventral striatal gating issues?

    <p>To improve reaction time and cognition</p> Signup and view all the answers

    During the sinusoidal protocol, what is the main reason for limiting cervical spine involvement?

    <p>To avoid sensory mismatches</p> Signup and view all the answers

    When should the yaw and pitch protocols be utilized?

    <p>As a warm up or light stimulation between sets</p> Signup and view all the answers

    What is a recommended starting point for anxious individuals during the basic protocol?

    <p>2 non-inverted spins</p> Signup and view all the answers

    What does the term 'Velocity Storage' in the context of gyrostim refer to?

    <p>Maintaining a constant velocity without acceleration/deceleration</p> Signup and view all the answers

    What should be done if a patient can tolerate stimulation during the All canals protocol?

    <p>Try without fixation at increasing speeds</p> Signup and view all the answers

    What is the intended outcome when patients engage in dual tasking during the basic protocol?

    <p>To enhance cognitive function and engagement</p> Signup and view all the answers

    Match the protocols with their primary purpose:

    <p>Basic Protocol = General visual/vestibular stimulation, increasing reaction time Yaw = Improves gaze stability for horizontal eye movement pathology Pitch = Improves gaze stability for vertical eye movement pathology Sinusoidal = Isolates visual/vestibular stimulation, limits C-spine involvement</p> Signup and view all the answers

    Match the canal focus with their associated eye movements:

    <p>R anterior canal = Forward pitch and left yaw L anterior canal = Forward pitch and right yaw RALP Canal = Specific canal designated for treatment LARP Canal = Specific canal designated for treatment</p> Signup and view all the answers

    Match the Gyrostim characteristics with their functions:

    <p>Constant velocity = Allows for consistent testing without acceleration Spin 360 degrees = Focus on specific canal during treatment Eyes fixated on target = Promotes gaze stability during stimulation Gentle stimulation = Encourages gradual adaptation for patients</p> Signup and view all the answers

    Match the nomenclature elements with their meanings in Gyrostim protocols:

    <p>VS = Velocity Storage 5 RPM = Rotations per minute A1 = Acceleration of 1 second D1 = Deceleration of 1 second</p> Signup and view all the answers

    Match the clinical considerations with their appropriate actions:

    <p>Check HR = Monitor heart rate and signs of fatigue Assess eye mm = Facilitate eye muscle response Facilitate presynaptic pools = Use time in between reps effectively Adjust stimulation = Determine patient tolerance level</p> Signup and view all the answers

    The nomenclature '5 RPM' in a custom protocol indicates the ______ per minute setting.

    <p>rotations</p> Signup and view all the answers

    The basic protocol is beneficial for individuals who have ______ striatal gating issues.

    <p>ventral</p> Signup and view all the answers

    The basic protocol combines head-eye integration and multiple ______ cancellations.

    <p>VOR</p> Signup and view all the answers

    What is the purpose of the Activate Mirror option?

    <p>To make both hands move like the dominant hand</p> Signup and view all the answers

    Freeze Motor Hand allows both hands to move freely without restrictions.

    <p>False</p> Signup and view all the answers

    What bodily posture should be maintained while using the balance platform?

    <p>Keep the body straight and do not bend at the waist, hips, or knees.</p> Signup and view all the answers

    The ___ duration determines how long the platform holds the tilt.

    <p>sustain</p> Signup and view all the answers

    In the Optical Flow program, what effect does a negative speed have?

    <p>Leads to posterior translation</p> Signup and view all the answers

    Match the following settings with their potential effects:

    <p>Max Tilt Angle = Increases or decreases platform tilt challenge Pause Duration = Affects difficulty between tilts Tilt Duration = Adjusts the time to reach the tilt Movements = Changes movement directions for patient needs</p> Signup and view all the answers

    Tilt mode is the preferred method for warm-up before starting impulsions.

    <p>True</p> Signup and view all the answers

    What type of stimulation is Optical Flow used for?

    <p>Visual flow and downregulating visual system.</p> Signup and view all the answers

    What is the primary purpose of the Motion Platform in the Virtualis system?

    <p>Where the patient stands for most therapies</p> Signup and view all the answers

    The Xbox Controller is required for the Bell’s Test module.

    <p>False</p> Signup and view all the answers

    What option should be selected to begin a therapy session?

    <p>Start a Session</p> Signup and view all the answers

    To calibrate the floor in the Virtualis system, set it to _____ inches.

    <p>8</p> Signup and view all the answers

    Which of the following is NOT used with the Virtualis system?

    <p>Joystick</p> Signup and view all the answers

    Match the equipment with its correct function:

    <p>Motion Platform = Patient's standing platform Headset = Visual immersion for therapy Vive Controllers = Interactive input for modules Base Stations = Track headset position</p> Signup and view all the answers

    What action is performed to finish a therapy session?

    <p>Press Enter</p> Signup and view all the answers

    In the Bell's Test, what does the environment setting control?

    <p>Difficulty and visual processing challenges</p> Signup and view all the answers

    What is the primary purpose of using the 'Mirror' setting during therapy?

    <p>Facilitate pain relief in chronic conditions</p> Signup and view all the answers

    Increasing the speed setting during head-eye coordination practice should be done right from the start.

    <p>False</p> Signup and view all the answers

    What visual element should be used for the control hand in the Mirror setting?

    <p>Choose a color closest to the patient's hand.</p> Signup and view all the answers

    The primary purpose of the Electrical Track is to facilitate ______ movement and motor control.

    <p>upper extremity</p> Signup and view all the answers

    Match the settings to their descriptions in head-eye coordination therapy:

    <p>Shapes = Progressively complex visual patterns ROM = Increases shape distance Speed = Initial focus on smoothness Reticle Size = Adjusts the size of the circle shown</p> Signup and view all the answers

    Which setting is essential for creating the visual effect that shows the left hand moving when the right hand is used?

    <p>Activate the Mirror</p> Signup and view all the answers

    What is the recommended initial position for patients during head-eye coordination exercises?

    <p>Seated</p> Signup and view all the answers

    The 'Radius' setting should always remain the same regardless of patient difficulty.

    <p>False</p> Signup and view all the answers

    Which of the following purposes is associated with the Optokinetic training?

    <p>Visual flow training</p> Signup and view all the answers

    The speed setting on the motion platform only allows for positive values.

    <p>False</p> Signup and view all the answers

    What should you tell patients to do if they feel dizzy during training on the motion platform?

    <p>Let me know and we can stop.</p> Signup and view all the answers

    The Subjective Visual Vertical (SVV) training uses a red line on the screen and a ___________ to turn the line in different directions.

    <p>controller</p> Signup and view all the answers

    Match the following training types with their primary purpose:

    <p>Optokinetic = Visual flow training Subjective Visual Vertical = Perceptual orientation testing Bird VR = Weight shifting training Platform Difficulty = Adjust platform movement intensity</p> Signup and view all the answers

    What adjustment can be made to increase the difficulty of the circles in the Bird VR training?

    <p>Decrease circles size</p> Signup and view all the answers

    The environment for the Optokinetic training can be customized with different visual settings.

    <p>True</p> Signup and view all the answers

    In the Optokinetic training, moving the horizontal orientation to a degree to match your angle requires a change to __________ degrees for vertical adjustments.

    <p>90</p> Signup and view all the answers

    What is the primary purpose of the butterflies task in therapy?

    <p>Enhancing ATNR reflex and visual tracking</p> Signup and view all the answers

    The 'Very Hard' setting in the butterflies task allows for targets with a preview of pathing.

    <p>False</p> Signup and view all the answers

    What type of training does the Limits of Stability Rehabilitation (LOS) focus on?

    <p>Weight shifting training</p> Signup and view all the answers

    In the Limits of Stability Rehabilitation, increasing the ______ size makes the task easier.

    <p>objective</p> Signup and view all the answers

    In the skiing exercise, what is the primary variable adjusted to change performance difficulty?

    <p>Forward speed</p> Signup and view all the answers

    Match the following therapy settings with their respective difficulty levels in the butterfly task.

    <p>Very Easy = Target is right in front and doesn’t move Easy = Target appears slightly left/right Medium = Target is further away Hard = Target path is not visible</p> Signup and view all the answers

    Patients must maintain a fixed position without any movements in the LOS rehabilitation.

    <p>False</p> Signup and view all the answers

    What should a patient do in the Limits of Stability Rehabilitation when they see a flower?

    <p>Sway in the direction of the flower and hold position until it disappears.</p> Signup and view all the answers

    Study Notes

    Gyrostim Operations

    • Power on by using the switch on the bottom left and switching on the computer.
    • Activate the Gyrostim by pressing the green button on the control panel and starting the software; proceed to calibrate and center the chair.
    • To turn off, shut down the software and computer, and set up the Gyrostim for the next use (harness and belts).

    Setting Up the Patient

    • Ensure all straps are unfastened and the steps are raised before the patient enters.
    • Instruct the patient to enter carefully and adjust the shoulder strap height as necessary.
    • Secure the 5-point harness and lap belt tightly, adjust the footrest so that knees are elevated slightly over thighs.
    • Position the patient’s feet together against the backrest and secure the feet belt before lowering the steps and closing the door.

    Program Usage

    • Create a new patient profile or select an existing one from the “Subject Information” tab.
    • Input mandatory details (last name, first name, gender, birthday, dominant hand) when creating a new profile.
    • Use the “RUN Gyrostim” tab for standard protocols or the “RUN Custom” for tailored protocols.

    Custom Protocols Nomenclature

    • Follow specific nomenclature for custom protocols for effective therapy, e.g., VS LA 5 RPM A1 D1 R1.
    • Each element reveals details: velocity, speed (RPM), acceleration, deceleration, and rotation specifications.

    Clinical Considerations

    • Gyrostim is designed for specific visual vestibular stimulation; establish goals before therapy begins.
    • Assess therapy intent: OPK stimulation, eye muscle facilitation, and determining stimulation phase speed (slow or fast).
    • Consider patient tolerance to stimulation, either x0 or x1.

    Basic Principles

    • Monitor patient well-being before, during, and after spins; check heart rate, signs of fatigue, and temperature.
    • Utilize rest periods effectively for enhancing presynaptic pool facilitation.
    • Incorporate complex movements, diverging and specific eye movements into the therapy.
    • Commence with 1 spin, gradually increasing to 2-3 spins based on patient's response; alternate speed and repetitions.
    • Recommended therapy duration is 10-20 minutes; note appointments on the sign-in sheet.

    Basic Protocol

    • Ideal for patients with ventral striatal gating issues (e.g., emotional instability, functional neurological disorders).
    • Aims to enhance visual and vestibular integration; utilize head-eye coordination and various vestibulo-ocular reflex (VOR) techniques.
    • Begin with mild stimulation for anxious patients, progressively increasing duration and complexity, involve cognitive tasks for engagement.

    Sinusoidal Training

    • Focuses on isolating visual/vestibular stimulation, minimizing cervical spine involvement to avoid sensory mismatches.

    Yaw and Pitch Exercises

    • Yaw: Enhances gaze stability and helps with horizontal eye movement disorders; ideal as a light warm-up.
    • Pitch: Targets vertical eye movement stability; also suitable as an initial warm-up.

    RALP/LARP Canal Plans

    • Individual patient assessment is essential to determine which canal needs more focus; direct the patient's gaze towards a target in the Gyrostim during 360-degree spins.

    Velocity Storage Protocol

    • Maintains constant spinning velocity without acceleration, crucial for evaluating vestibular function.
    • Focuses on stimulating weak eye muscles and activating brainstem integrators.
    • Begin stimulation with a fixation point at slow speeds, gradually advance speed and incorporate problem-solving tasks for patients who tolerate the initial session.

    Gyrostim Operation

    • Turning On

      • Activate the power switch on the bottom left of the Gyrostim and turn on the computer.
      • Press the green button on the control panel adjacent to the computer.
      • Launch Gyrostim software, then select "Calibrate" and "Center chair."

    • Turning Off

      • Access the main tab, close the program, and shut down the computer.
      • Prepare Gyrostim for next use: fasten the 5-point harness, lap belt, and feet belt; ensure the steps are down.
      • Deactivate the power switch on the Gyrostim.

    Patient Setup

    • Ensure all straps are unfastened and loosened before beginning.
    • Guide the patient in, advising caution for head space.
    • Adjust the shoulder strap height and secure the 5-point harness belts.
    • Tighten the lap belt and adjust the footrest for optimal knee elevation.
    • Instruct the patient to place feet together against the back rest and secure the feet belt.
    • Lower the entry steps and close the door post-setup.

    Program Utilization

    • Create or select a patient profile in the “Subject Information” tab.
    • For a new profile, click “Add NEW Subject” and input last name, first name, gender, birthdate, and dominant hand.
    • Use “RUN Gyrostim” for standard protocols or “RUN Custom” for tailored protocols.

    Custom Protocol Nomenclature

    • Custom protocols follow a specific nomenclature for proper use, e.g., "VS LA 5 RPM A1 D1 R1".
      • VS: Velocity Storage, LA: Left Anterior Canal
      • 5 RPM: Rotations per minute (speed), A1: Acceleration of 1 second
      • D1: Deceleration of 1 second, R1: Rotation of 1.

    Clinical Considerations

    • Gyrostim delivers visual vestibular stimulation; outline therapy goals before use.

      • Options include OPK stimulation, eye muscle facilitation, phase response, and patient tolerance.

    • Monitor patient responses: check heart rate, signs of fatigue like sweaty palms or pupil dilation.

    • Use recovery time between spins for additional exercises, optimizing facilitation effects.

    • Gradually escalate spins based on patient tolerance and feedback.

    • Allocate 10-20 minutes per session and manage sign-in sheet reservations.

    Basic Protocol

    • Designed for patients with ventral striatal gating issues, ideal for those with emotional instability or attention disorders.
    • Focuses on head-eye integration and vestibulo-ocular reflex (VOR) cancellations.

    Sinusoidal and Yaw/Pitch

    • Sinusoidal Stimulation: Isolates visual/vestibular effects, allows limited C-spine movement, promotes cross-axis adaptation.
    • Yaw: Improves gaze stability and ocular control in horizontal movements. Recommended as a warm-up or light in-between stimulus.
    • Pitch: Enhances gaze stability in vertical movements with similar warm-up recommendations.

    RALP/LARP Canal Focus

    • Identify the more affected canal for targeted protocol application.
    • Patients should fixate on a target while rotating 360 degrees in the Gyrostim.

    Velocity Storage Insights

    • Gyrostim typically maintains constant velocity with no accelerating or decelerating phases during tests.
    • Anterior Canal Connections: Right anterior correlates with forward pitch and left yaw, while left anterior links to forward pitch and right yaw.
    • Purpose: Stimulation targets weak eye muscles and central integrators in the brainstem.
    • Position the patient to look at a fixed point for gentle stimulation, adjusting speed based on tolerance and response.

    Gyrostim Operation

    • Turning On

      • Activate the power switch on the bottom left of the Gyrostim and turn on the computer.
      • Press the green button on the control panel adjacent to the computer.
      • Launch Gyrostim software, then select "Calibrate" and "Center chair."

    • Turning Off

      • Access the main tab, close the program, and shut down the computer.
      • Prepare Gyrostim for next use: fasten the 5-point harness, lap belt, and feet belt; ensure the steps are down.
      • Deactivate the power switch on the Gyrostim.

    Patient Setup

    • Ensure all straps are unfastened and loosened before beginning.
    • Guide the patient in, advising caution for head space.
    • Adjust the shoulder strap height and secure the 5-point harness belts.
    • Tighten the lap belt and adjust the footrest for optimal knee elevation.
    • Instruct the patient to place feet together against the back rest and secure the feet belt.
    • Lower the entry steps and close the door post-setup.

    Program Utilization

    • Create or select a patient profile in the “Subject Information” tab.
    • For a new profile, click “Add NEW Subject” and input last name, first name, gender, birthdate, and dominant hand.
    • Use “RUN Gyrostim” for standard protocols or “RUN Custom” for tailored protocols.

    Custom Protocol Nomenclature

    • Custom protocols follow a specific nomenclature for proper use, e.g., "VS LA 5 RPM A1 D1 R1".
      • VS: Velocity Storage, LA: Left Anterior Canal
      • 5 RPM: Rotations per minute (speed), A1: Acceleration of 1 second
      • D1: Deceleration of 1 second, R1: Rotation of 1.

    Clinical Considerations

    • Gyrostim delivers visual vestibular stimulation; outline therapy goals before use.

      • Options include OPK stimulation, eye muscle facilitation, phase response, and patient tolerance.

    • Monitor patient responses: check heart rate, signs of fatigue like sweaty palms or pupil dilation.

    • Use recovery time between spins for additional exercises, optimizing facilitation effects.

    • Gradually escalate spins based on patient tolerance and feedback.

    • Allocate 10-20 minutes per session and manage sign-in sheet reservations.

    Basic Protocol

    • Designed for patients with ventral striatal gating issues, ideal for those with emotional instability or attention disorders.
    • Focuses on head-eye integration and vestibulo-ocular reflex (VOR) cancellations.

    Sinusoidal and Yaw/Pitch

    • Sinusoidal Stimulation: Isolates visual/vestibular effects, allows limited C-spine movement, promotes cross-axis adaptation.
    • Yaw: Improves gaze stability and ocular control in horizontal movements. Recommended as a warm-up or light in-between stimulus.
    • Pitch: Enhances gaze stability in vertical movements with similar warm-up recommendations.

    RALP/LARP Canal Focus

    • Identify the more affected canal for targeted protocol application.
    • Patients should fixate on a target while rotating 360 degrees in the Gyrostim.

    Velocity Storage Insights

    • Gyrostim typically maintains constant velocity with no accelerating or decelerating phases during tests.
    • Anterior Canal Connections: Right anterior correlates with forward pitch and left yaw, while left anterior links to forward pitch and right yaw.
    • Purpose: Stimulation targets weak eye muscles and central integrators in the brainstem.
    • Position the patient to look at a fixed point for gentle stimulation, adjusting speed based on tolerance and response.

    Virtualis Equipment

    • Motion Platform: Primary therapy area for patients to stand during sessions.
    • Base Stations: Maintain the headset's line of sight for uninterrupted video.
    • Headset: Used for modules not displayed on TV.
    • Vive Controllers: Required for specific modules.
    • Trackers: Used when patients cannot hold controllers or need foot tracking.
    • Xbox Controller: Essential for the Ocular Tilt module.

    General Instructions

    • Turn on motion platform, wait for calibration, then start computer.
    • Vive Console initiates followed by automatic loading of SteamVR.
    • Conduct room calibration while wearing goggles, ensuring "Calibrate Floor" is set at 8 inches.
    • Log into Virtualis software using password Norcalbraincenter1.
    • To shut down, exit Vive Console, turn off the platform, and shut down the computer.

    Using the Program

    • Create or select a patient profile.
    • Input necessary patient data: Last Name, First Name, Height, Birthdate, and Sex.
    • Start a session by selecting a desired module.
    • Important hotkeys:
      • C: Center patient’s vision
      • Spacebar: Start/pause session
      • Enter: Finish
      • ESC: Quit

    Patient Setup

    • Headset Fitting: Ensure the patient is seated, adjust headset snugly, avoiding contact that causes blackouts.
    • Motion Platform Positioning: Feet should be shoulder-width apart, with lateral malleolus aligned horizontally.

    Bell’s Test

    • Assesses hemi-spatial awareness/unilateral neglect, starting seated, progressing to standing.
    • Adjust difficulty by altering target distance and environment challenge.

    Electrical Track Module

    • Focus on upper extremity movement and motor control using leap motion and controllers.
    • Key features include mirror functionality and customizable routes for hand movement tracking.

    Head-Eye Coordination

    • Enhances cervical proprioception; starts with simple shapes, increasing difficulty as needed.
    • Aim for smooth head movements to keep visual targets within a designated area.

    Mirror Module

    • Utilizes mirror-box therapy for chronic pain and neglect.
    • Simple hand movements practiced while focusing on non-dominant hand.

    Motion Program

    • Prioritizes postural reflexes and balance through platform movements.
    • Difficulty settings allow for progressive challenge adjustments.

    Optical Flow Module

    • Engages the patient in visual flow tasks, adaptable for different levels of sensitivity.
    • Incorporates platform movement to enhance vestibular engagement.

    Optokinetic Module

    • Visual flow training via environmental movement, adjustable for intensity and orientation.

    Subjective Visual Vertical (SVV)

    • Tests perceptual orientation; patients use controllers to align visual indicators.

    KIDS Programs

    • Bird VR: Targets weight shifting while using controllers to navigate through challenges.
    • Bow VR: Focuses on reflexes and timing as patients simulate archery movements.
    • Limits of Stability Rehabilitation (LOS Rehab): Practicing weight shifts and body control.
    • Ski: Enhances weight shifting in a simulated skiing environment, controlling forward speed.

    Session Guidance

    • Ensure involvement of both physical and cognitive processes to engage patients fully while monitoring difficulty levels to prevent frustration or boredom.

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    Related Documents

    Gyrostim Instructions PDF
    Virtualis PDF

    Description

    This quiz covers the essential steps for operating the Gyrostim, including turning it on and off. It details the calibration process and safety harness setup, ensuring users can efficiently operate the system. Perfect for training and familiarizing oneself with the Gyrostim equipment.

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